Tod J. Curtis, DDS, MS
Specialist in Orthodontics

 

2610 Smile Lane
Bedford, IN 47421

 

(812) 279-9473

(888) 998-9473

General Questions

Fees, Payment Plans, and Insurance

Treatment Questions

Care Questions

  • Question: Should I buy a mechanical toothbrush to use with my braces?

    I think it can be easier to take care of braces with a mechanical toothbrush, but you can save money and do just as well with a regular toothbrush and some effort. It is very important to keep the teeth very clean when the braces are on. If plaque is allowed to sit around the edges of the brackets, decalcification (loss of mineral) around the bracket can occur. When the braces come off white lines are visible from the decalcification. It is very difficult to cover up and doesn't go away. Removing the plaque carefully with a toothbrush is the best way to avoid decalcification. I used a Water-Pik during when I had braces and thought it did a good job of spraying out food that was caught in the brackets and wires. These aren't very expensive and can be found at local drugstores and other stores. However, they are not a substitute for proper brushing. So, mechanical gadgets are completely optional. If you like them, use them. If not, a regular toothbrush will work just fine.

  • Question: Should I use fluoride rinses with my braces?

    In general, fluoride rinses (such as ACT) shouldn't do any harm and may help keep the surface of the teeth healthy during treatment. However, the effect is not great and keeping the teeth very clean is much more important than the fluoride. Recently, many new topical fluorides, or prescription fluorides, have been introduced as a way to help prevent demineralization (the white areas) during orthodontic treatment. Patients who have not shown the motivation to keep their teeth clean may be asked to use these products. But, the journal Oral Health (September 1999) advises against routine use of fluoride in orthodontic patients because of difficulties in judging how much fluoride is getting into the patient's body, which can be harmful. So, in general, feel free to use the inexpensive fluoride rinses during orthodontic treatment but don't get the idea that they will substitute for poor oral hygiene.

  • Question: Can I be treated with a retainer only?

    There are very few things that can be accomplished with a retainer. For the most part, retainers are only useful at holding (retaining) the teeth in a set position. After braces, retainers are required to keep the teeth from moving back to where they started. Even after a number of years, nature will start trying to make your teeth crooked again. So nighttime retainer wear is a must as long as you want your teeth to remain straight. One of the things that a retainer can do is move one or two teeth forward. A spring is put in the retainer to push and the tooth moves quite easily. This is useful in fixing an upper front tooth that has come in behind the bottom teeth. Sometimes a retainer can be used to straighten bottom front teeth that are slightly crooked. Otherwise, most problems are best treated with braces, then held with a retainer.

  • Question: Can adults have braces?

    Definitely! There are few limitations on moving teeth based on age. As a matter of fact, the number of adult patients is growing and accounts for more than 25% of new patients in most orthodontic offices. Treatment times are sometimes a little longer because your jaw bones are fully developed and the teeth may move slower, but are certainly reasonable. The biggest problem is that we can no longer change the growth of your face, so more treatment plans rely on surgery or a compromise. On the plus side more adults have braces now, so your co-workers are not as likely to pick on you. Also, modern ceramic brackets are tooth-colored and much less visible. The braces might even make you look younger while they're on, and after treatment you'll be able to show off a beautiful smile.

  • Question: Can you put braces on the back (tongue side) of the teeth?

    It is possible to do lingual (tongue side) orthodontics. However, there are a number of disadvantages. First of all, having brackets where your tongue usually moves can be quite uncomfortable. Second, this technique is considerably more difficult to control. The mechanics of the wires and moving teeth are very different on the inside of the arc rather than the outside. Since treatment is more difficult usually lingual braces are significantly more expensive than the traditional method. This technique began a ride in popularity in the 1970's and has since slipped, due in part to the development of tooth-colored ceramic braces. There are still a number of orthodontists who offer lingual appliances, but I have not found it to be worthwhile. Instead, I prefer the clear braces that are much less noticeable than the standard metal brackets. This helps hide the braces but allows treatment to move along much more easily and efficiently.

The Weird and the Wacky

  • Question: Are crooked teeth hereditary?

    You may have noticed that your child has the same overbite or the same crowding that you once had (or still do). Did they inherit this? To some degree, yes. Orthodontists often see the same skeletal and dental patterns between children and their parents, and between the children themselves. Often, identical twins will have very similar problems. The environment plays a pretty big role, too, so it is hard to tell what is hereditary and what is not. There are some problems that are seen quite often in a family tree. Having a very strong lower jaw (one that sticks out) or a very weak lower jaw (like Barney Fife) can often be seen among many members of the same family. Having missing permanent teeth also seems to run in the family. Most ethnic groups have their own tendency toward certain orthodontic problems. A patient's heritage actually plays a role in treatment planning, because an understanding of these tendencies may influence the goals of treatment. Unfortunately, for all ethnic groups, the tendency toward crowding and other orthodontic problems is increasing with each new generation, so a natural perfect smile may someday become extinct.

  • Question: Who was the first person to do orthodontics?

    According to my first textbook in orthodontics, by William Proffit, attempts to correct crowded, irregular, and protruding teeth go back to at least 1000 B.C.! Ancient orthodontic appliances have been found in both Greek and Etruscan materials. Dentistry developed in the eighteenth and nineteenth centuries, and various devices were invented to move the teeth. Many are similar to devices that are sometimes used today. The first good source of information on doing orthodontics was published around 1850 by Norman Kingsley. Edward Angle is considered the true father of orthodontics, and his influence began around 1890. The specialty of orthodontics is the oldest in dentistry, and many schools trained orthodontists starting in the early 1900's. Orthodontics has changed significantly in the last 30 years. The brackets and wires are smaller, as are the resulting forces on the teeth. Technology allows orthodontists to work more efficiently and provide better diagnosis and treatment planning. Evidence-based treatment is gaining hold, which means that science is proving what really works and what really doesn't. As we go further into the new millennium, the quality of treatment should continue to improve significantly.

  • Question: Why did you want to be an orthodontist?

    Good question! To tell you the truth, I don't remember exactly why I wanted to be an orthodontist. I wanted to be a computer scientist and spent most of my school life planning for that. My senior year in high school a good friend of mine decided he wanted to be a dentist, and the details seemed pretty good. I had just gotten out of braces, and I started to think about being an orthodontist. Computer scientists spent most of their time fairly isolated in those days, and the technology was not as cool to work with as it is today. I wanted to be able to see lots of people every day and build relationships, and I didn't think that would happen in computer science. Orthodontics is similar to programming because you spend most of your time finding ways to solve problems and you have to think in a logical and straightforward manner. So, I planned on using my skills to be an orthodontist and never looked back - which is good because I love it!

  • Question: Why does it take so long to straighten teeth?

    Most orthodontic treatment performed by an orthodontist will take around 2 years to complete, and sometimes longer. You may notice that your teeth look straight after a few months. So what is the orthodontist doing? The orthodontist cares about straightening the teeth, of course, but also wants them to fit together ideally. If the jaws do not match up well, then it takes more time (and usually effort) to get the teeth to fit right. Every effort to move one tooth one way causes the others to move the opposite way. In order to maintain control the orthodontist will focus on problems one at a time until they are all taken care of. Also, teeth do not move very quickly. The body has to remove bone to make way for the teeth and fill in the bone afterwards. Sometimes teeth have to move a long way in the bone and take a while to get where they need to be. Adding more force doesn't make them move faster. In fact, they move quite quickly with very little force. The orthodontist will spend the last months of treatment making very small movements to improve the final look of the teeth. Then the braces come off and hopefully the beautiful smile was worth the time invested!